Thiamine as Adjunctive Therapy in COVID-19 Critically Ill Patients

 

Khalid Al Sulaiman, Ohoud Aljuhani, Maram Al Dossari, Asma Alshahrani, Aisha Alharbi, Rahmah Algarni, Majed Al Jeraisy, Shmeylan Al Harbi, Abdulmalik Al Katheri, Fahad Al Eidan, Abdulkareem M. Al Bekairy, Nouf Al Qahtani, Mashael Al Muqrin, Ramesh Vishwakarma, Ghassan Al Ghamdi

DOI: https://doi.org/10.21203/rs.3.rs-400565/v1

PDF: https://www.researchsquare.com/article/rs-400565/v1.pdf

Background: Thiamine is a precursor of the essential coenzyme thiamine pyrophosphate (TPP) required for glucose metabolism; it improves the immune system function and has been shown to reduce the risk of several diseases. The role of thiamine in COVID-19 critically ill patients is still unclear, however, its role in the critically ill septic patient has been addressed in multiple studies. The objective of this study was to evaluate the use of thiamine as adjunctive therapy on the mortality in COVID 19 critically ill patients.

Methods: This is a multicenter, non-interventional, retrospective cohort study for all critically ill patients admitted to intensive care units (ICUs) with a confirmed diagnosis of COVID19. All patients aged 18 years or older who were admitted to ICUs between March 1^st to December 31^st, 2020 with positive PCR COVID-19 were included in the study. We investigated the association between thiamine use as an adjunctive therapy and clinical outcomes in COVID -19 after propensity score matching using baseline severity scores, systemic use of corticosteroids and study centers.

Results: A total of 738 critically ill patients with COVID-19 who had been admitted in ICUs at the two governmental hospitals included in the study. Among 166 patients matched using propensity score, 83 had received thiamine as adjunctive therapy. There was significant association between thiamine use with in-hospital mortality (OR=0.49; 95% CI = 0.25- 0.97; P=0.04) as well with 30-day ICU mortality (OR=0.45; 95% CI = 0.215- 0.935; P=0.03). Moreover, patients who received thiamine as an adjunctive therapy were less likely to have thrombosis during ICU stay by 81 % (OR (95%CI): 0.19 (0.040,0.884), p-value=0.034).

Conclusion: Thiamine use as an adjunctive therapy may have potential survival benefits in critically ill patients with COVID-19.

https://www.researchsquare.com/article/rs-400565/v1